Members are asked to consider whether they have any disclosable pecuniary interests and/or any other relevant interest in connection with any item(s) on this agenda and, if so, to declare them and state the nature of the interest.

Members are reminded that they should also declare whether they are subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.

Members were asked to consider whether they had any disclosable pecuniary interests and/or any other relevant interest in connection with any item(s) on this agenda and, if so, to declare them and state the nature of the interest.

Members were reminded that they should also declare whether they were subject to a party whip in connection with any item(s) to be considered and, if so, to declare it and state the nature of the whipping arrangement.

The following interests were declared:

To approve the accuracy of the minutes of the People Overview and Scrutiny Committee meeting held on 8 September 2016, and to receive the minutes of the Children’s Sub Committee meeting held on 22 September 2016.

Resolved - That the minutes of the last meeting of the People Overview and Scrutiny Committee, held on 8 September 2016, and the minutes of the Children’s Sub Committee meeting held on 22 September 2016, be confirmed as a true record.

At the meeting of the Council held on 17 October 2016 (minute 67 (1) refers), the attached Notice of Motion, ‘Motor Neurone Disease Charter’ proposed by Councillor Steve Williams and seconded by Councillor Chris Blakeley was referred by the Mayor to the People Overview and Scrutiny Committee for consideration.

In accordance with Standing Order 7 (6), Councillor Williams has been invited to attend the meeting in order for him to be given an opportunity to explain the Motion.

The Chair of the People Overview and Scrutiny Committee reported that at the meeting of the Council held on 17 October 2016 (minute 67(1) refers), the following Notice of Motion proposed by Councillor Steve Williams and seconded by Councillor Chris Blakeley was referred by the Mayor to this Committee for consideration –

“That this Council adopts the Motor Neurone Disease (MND) Charter and thereby supports achieving quality of life, dignity and respect for people with MND and their Carers.

The Charter:

1.  People with MND have the right to an early diagnosis and information.

This means:

a)  An Early referral to a Neurologist

b)  An accurate and early diagnosis, given sensitively

c)  Timely and appropriate access to information at all stages of their condition

2.  People with MND have the right to access quality care and treatments.

This means:

a)  Access to co-ordinated multidisciplinary care managed by a specialist key worker with experience of MND.

b)  Early access to specialist palliative care in a setting of their choice, including equitable access to hospices.

c)  Access to appropriate respiratory and nutritional management and support, as close to home as possible.

d)  Access to the drug riluzole.

e)  Timely access to NHS continuing healthcare when needed.

f)  Early referral to social care services.

g)  Referral for cognitive assessment, where appropriate.

3.  People with MND have the right to be treated as individuals and with dignity and respect.

This means:

a)  Being offered a personal care plan to specify what care and support they need.

b)  Being offered the opportunity to develop an Advance Care Plan to ensure their wishes are met, and appropriate end-of-life care is provided in their chosen setting.

c)  Getting support to help them make the right choices to meet their needs when using personalised care options.

d)  Prompt access to appropriate communication support and aids.

e)  Opportunities to be involved in research if they so wish.

4.  People with MND have the right to maximise their quality of life.

This means:

a)  Timely and appropriate access to equipment, home adaptations, environmental controls, wheelchairs, orthotics and suitable housing.

b)  Timely and appropriate access to disability benefits.

5.  Carers of people with MND have the right to be valued, respected, listened to and well supported

This means:

a)  Timely and appropriate access to respite care, information, counselling and bereavement services.

b)  Advising carers that they have a legal right to a Carer’s Assessment of their needs, ensuring their health and emotional well-being is recognised and appropriate support is provided.

c)  Timely and appropriate access to benefits and entitlements for carers.”

Councillor Steve Williams tabled the Motion, and introduced Ms Debbie Williams of the Wirral MND Association who then addressed the People Overview and Scrutiny Committee.

Ms Williams expressed her thanks to all those who had responded to their recent petition, requesting adoption of the Motor Neurone Disease (MND) Charter.

Ms Williams provided Members with an explanation of the disease, which has no cure, informing that the Charter  ...  view the full minutes text for item 27.

At the meeting of the Council held on 17 October 2016 (minute 67 (5) refers), the attached Notice of Motion, ‘Performance Management Reporting Arrangements’ proposed by Councillor Phil Gilchrist and seconded by Councillor Stuart Kelly was referred by the Mayor to the People, Environment and Business Overview and Scrutiny Committees for consideration.

In accordance with Standing Order 7 (6), Councillor Gilchrist has been invited to attend the meeting in order for him to be given an opportunity to explain the Motion.

The Chair of the People Overview and Scrutiny Committee reported that at the meeting of the Council held on 17 October 2016 (minute 67(5) refers), the following Notice of Motion proposed by Councillor Phil Gilchrist and seconded by Councillor Stuart Kelly was referred by the Mayor to this Committee for consideration –

“PERFORMANCE MANAGEMENT – REPORTING ARRANGMENTS

Council notes:

1.  the training session on the arrangements for Performance Management held on 7September 2016, attended by a wide range of Members across all parties, at which Members were informed regarding the range of indicators chosen for future reports based on the progress with the Wirral Plan;

2.  the concern expressed at that meeting that these reports and proposed indicators do not cover the range of established indicators that Council Members have always followed and expected to see, such as progress with staff appraisals, the level of staff sickness and absence and other issues;

3.  that many Members at the training session made the case for a wider range of indicators to show how Council services are performing;

4.  that the former Families and Wellbeing Policy & Performance Committee received performance monitoring data on a range of indicators that are and remain sensitive and significant in the light of OFSTED’s recent findings.

Council, therefore, requests that:

(i)  as the data is still being collected and analysed by officers, a set of such wider indicators should be presented to Members on a regular basis;

(ii)  accompanying quarterly performance data, there should also be information as to the target expected in that quarter, in addition to the year end and Plan end (2020) target;

(iii)  the choice of indicators needs to be relevant to the 2020 pledge and undertakes to review those indicators chosen to measure pledge success prior to reporting for Quarter 2 performance;

(iv)  officers report to each Overview and Scrutiny committee the ‘added value’ expected for those indicators that have been included within the 2020 Vision Plan and, in respect of indicators flagged as under or over preforming, additional information and actions proposed in respect of those indicators.

In order to secure a transparent and open review, Members should be invited to submit details of the key areas that they wish to see reported upon by the end of October.

The Spokespersons of each of the newly created Overview and Scrutiny Committees should be requested to examine these suggestions and ensure a sufficient, timely and readily accessible mechanism for such data in future reports.”

Councillor Phil Gilchrist introduced the Motion and set out his views on the various elements of the Motion, suggesting a ‘back-to-basics’ approach and general methodology in relation to data gathering and reporting both past and present. He explained the difficulties that could be faced by the re-definition of data-sets and problems that this can cause with regard to performance measurement over time. He further requested that the need for Members’ access to data, to ensure essential monitoring of corporate performance. Councillor Gilchrist then also  ...  view the full minutes text for item 28.

Carla Sutton, Senior Contract Manager, NHS England North (Cheshire & Merseyside) introduced the report of the NHS Commissioning Board (NHS CB) (NHS England) that outlined proposals to provide a fairer, more equitable access for GP services over seven days per week and outside of normal core hours at a large scale in multiple hubs in key locations, to all Wirral residents, away from the main Hospital site at Wirral University Teaching Hospital (WUTH) Arrowe Park, Hospital site, Upton, Wirral.

Ms Sutton informed that the current service provided was not geographically equitable, and that Clinical Commissioning Groups were required to review service provisions and commission routine appointment services at evening and weekends to meet demand, in addition to providing additional investment for improved IT access to patient records.

Martyn Kent, Head of Primary Care Transformation, NHS Wirral Clinical Commissioning Group apprised Members that NHS Wirral Clinical Commissioning Group was developing a proposal to offer a new pilot service to deliver upon this requirement via the two emerging GP Federations on Wirral from early 2017. The pilot process would be used to review the outcomes associated with the service and revise the model to ensure it met the needs of the Wirral population.

Mr Kent also informed that the new pilot service would provide access to GP services at a number of hub sites across Wirral in each of Wirral’s four Parliamentary constituencies. The aim of the service being to improve the experience of patients accessing GP services who sometimes have difficulty now, for example:

a)  Working people

b)  Carers

c)  People with young families

The proposed delivery sites, subject to contract procurement (December 2016) and confirmation thereafter, include:

a)  Civic Medical Centre (Bebington)

b)  Claughton Medical Centre (Claughton/Oxton)

c)  Eastham Group Practice (Eastham)

d)  St Hilary Group Practice (Wallasey)

e)  Marine Lake Medical Practice (West Kirby)

f)  Miriam Medical Centre (Birkenhead)

g)  Parkfield Medical Centre (New Ferry)

h)  Somerville Medical Centre (Wallasey)

Mr Kent explained that the initial funding for the service provided by NHS England of approximately £1 per Wirral patient (£340,000) only allowed a limited service to be piloted initially in 2017/18 i.e. 138 GP appointments per week). However the budget for the service would increase to £3.34 in 2018/19 and £6 per Wirral GP registered patient in 2019/20 (circa £2,000,000) as per NHS Planning and Contracting Guidance 2017-2019.

The report informed that the All Day Health Centre at Arrowe Park had a very low registered practice list (approximately 600 patients, in comparison to the average practice size of 6000 patients). The patients were evenly spread acrossWirral, although some patients had historically followed a GP from the Leasowe area, who worked at the service. However, Members heard that without the funding for the wider Primary Medical Care service, maintaining the registered list was not a viable option as a stand-alone service, and a patient engagement exercise had commenced with those persons on the registered patient list regarding its dispersal.

Resolved –  ...  view the full minutes text for item 29.

The Chair introduced the item, that comprised of the report of the Director of Health and Wellbeing that had been written at the Chair’s request, statistics of the cause of death for people in contact with the Wirral Ways to Recovery (WWTR), and recommendations arising from the WWTR self-assessment. The report focused on the 72 reported deaths of people in contact with the WWTR service over the period, 1 February 2015 to 31 August 2016. The 72 deaths were the result of a wide range of causes, with a significant percentage being associated with long term health conditions.  

The Director of Health and Wellbeing reported that every death in Wirral relating to drugs or alcohol misuse was a tragedy, particularly for the families and friends of the person who had died, and that addiction created an increased chance of death and poor health in any individual.

The People Overview and Scrutiny Committee noted that the report had been written in response to concerns raised through an Elected Member regarding the number of deaths of people in contact with the service managed by Change, Grow, Live (known as CGL). A particular concern raised was that since the new service had taken over from the previous NHS service there were significantly more deaths in service. As a result of the concern raised, a review of all deaths in the service had taken place to understand whether there was any reason to believe that the service was unsafe, and whether Wirral was unusual in the numbers of deaths relating to drugs and alcohol misuse. The report set out the findings of the review.

The Director of Health and Wellbeing reported that Wirral’s system had been good at getting people into treatment and had therefore a higher than average number of people recorded within the system compared to other Councils, which in turn led to higher than average number of reportable deaths in the service.

From the evidence reviewed and presented in the report the Director of Health and Wellbeing further explained that there was no evidence to support CGL were operating an unsafe service. However nationally and locally there was a growing recognition of the need for a greater focus on the general health and wellbeing of service users, and the Council and CGL would therefore be taking action to:

·  ensure that the complex needs of people who use drugs and alcohol are met through a co-ordinated, whole-system approach that address health inequalities and provides better access to physical healthcare and psychiatric care, along with other support which could include housing and employment; and

·  ensure a balanced approach in the treatment service to ensure those that need treatment receive it and those who wish to embrace the recovery model get the help and support they need.

The People Overview and Scrutiny Committee noted that these actions were to be progressed via both scheduled contract meetings with Wirral Ways to Recovery and the development of local pathways to meet the needs of a complex  ...  view the full minutes text for item 30.

Presentation from Wirral CCG to provide an update on the enclosed Cheshire & Merseyside Sustainability and Transformation Plan published 15 November, 2016 (summary document and detailed report enclosed)

Mr Phil Meakin introduced a presentation entitled “Healthy Wirral - Development of Local Delivery Service Plans (LDSPs) and Sustainability & Transformational Plans (STPs)”. The presentation provided the People Overview and Scrutiny Committee with an update on the priorities, delivery and action plans for the Cheshire & Merseyside NHS Sustainability and Transformation Plan, namely:

·  Support for people to live better quality lives: Alcohol, smoking, poor diet and inactivity have a negative impact on our lives and are increasing demands on the NHS. We have to change this;

·  Working together with partners in social care and the voluntary sector to provide better, more joined up care: Better care  provided in the community, enabling reduced hospital admissions; 

·  Designing hospital services to meet modern clinical standards and reducing variation in quality: people will receive consistently high standards of care wherever they live; and

·  Being more efficient by reducing duplication and using the latest technology: reducing costs in managerial and administrative areas: sharing electronic information and adopting new innovative ways of working.

MrMeakin informed that the initial phases of the Plan comprised project initiation and design, to be followed by public consultation. He confirmed that this was part of a National programme and that there had been much media and public interest – together with concerns and raised levels of anxiety surrounding the project. He re-iterated that any new proposals would be the subject of public consultation during the identified stage of the programme, and for additional clarity there were no proposals to merge hospitals within the Cheshire and Wirral Local Delivery Service (LDS) footprint (i.e. Arrowe Park and the Countess of Chester Hospitals) or to build a new hospital at Ellesmere Port, or to downgrade Accident and Emergency Services at Wirral University Teaching Hospital (WUTH), Arrowe Park.

Members were pleased to receive such assurances, but expressed their concerns that the Council as a local NHS partner had not been involved during the early stages of the project initiation.

Members provided a number of further observations on explorative proposals for elective care provision at Clatterbridge, the continued need for meaningful consultation, assurance regarding safe staffing levels, and the travel and transport needs for patients accessing services. 

Resolved - That

•  the People Overview and Scrutiny Committee thanks Mr Phil Meakin for his attendance and presenting of the key points of the Sustainability and Transformation Plan (STP);

•  the People Overview and Scrutiny Committee is concerned that Elected Members have had no opportunity to feed into the development of the STP, nor given the opportunity to see the Plan prior to its publication on 23 November 2016;

•  the People Overview and Scrutiny Committee is also concerned about the lack of any meaningful consultation with the public of Wirral prior to the publication of the Plan;

•  the People Overview and Scrutiny Committee is further concerned at the high levels of anxiety and speculation over the implications for future delivery of health services in Wirral generated by the Plan - as a result of lack  ...  view the full minutes text for item 31.

The Chair introduced the report that provided the 2016/17 Quarter 2 (July – September) performance report for Wirral Plan pledges under the People theme. The report, which was included as Appendix 1, provided a description of the progress in Quarter 2 as well as providing available data in relation to a range of outcome indicators and supporting measures. 

The report informed that at quarter 1, a range of feedback was provided by each of the Overview and Scrutiny Committees on the reports provided. Following this, officers had met with the Committee Chairs and Spokespersons to review report provision. The report piloted an approach agreed at that session to provide more detail in terms of performance against each of the pledges that fell under the remit of the People Overview and Scrutiny Committee.

Resolved – That the report be noted.

The People Overview and Scrutiny Committee received a report of the Acting Section 151 Officer that set out the financial monitoring information for this Committee. The report provided a basis for Members to scrutinise budget performance and set out the projected revenue and capital monitoring position for 2016/17, as at close of quarter 2 (30 September 2016) and as reported to Cabinet on 8 December 2016.

The People Overview and Scrutiny Committee noted that the quarter two revenue forecast an overall underspend of £0.2 million for the year (£1.1 million overspend was forecast at quarter 1) and that the Families and Wellbeing / DASS and Children overspend had increased during the period but had been compensated for by increased savings within treasury management.

The Committee further noted that the quarter two capital report had updated the capital programme and reflected significant re-profiling of schemes between years to reduce the 2016/17 capital programme to £38.1 million and that expenditure after the second quarter concluded was £10.6 million.

Resolved - That the report and appendices be noted.

The People Overview and Scrutiny Committee received the report of the Executive Director for Strategy that set out proposed amendment to the terms of reference for the Children Sub Committee.

The report informed that the PeopleOverview & Scrutiny Committee had approved the terms of reference for the Children Sub Committee at the meeting held on 14 July 2016, and that subsequently, the terms of reference were presented, for information, to the Sub Committee’s first meeting of the municipal year on 22 September 2016.

Members of the Sub Committee had proposed that the terms of reference should give greater prominence to the Wirral Plan pledges that were relevant to the work of the Sub Committee and therefore, an amended version of the terms of reference had been prepared adding a new section entitled ‘Wirral Plan Pledges’. The proposed amendment  included the following text:

“WIRRAL PLAN PLEDGES

The work of the Children Sub-Committee will focus in particular on the delivery of the following Wirral Plan Pledges:

• Children are ready for school;
• Young people are ready for work and adulthood;
• Vulnerable children reach their full potential.”

A Member proposed that a further pledge be included, to:

• Reduce Child and Family Poverty

No other changes to terms of reference were proposed.   

Resolved – That the terms of reference for the Children Sub Committee as amended be approved.

The Chair of the People Overview and Scrutiny Committee introduced her report that provided feedback on a meeting of the Health & Care Performance Panel that had taken place on the 5 October 2016.

The report informed on a number of key points that included:

• CQC Inspection of Wirral University Teaching Hospital (WUTH) – Action Plan Update.
• Social Care Annual Complaints and Customer Feedback Report – 2015/16. 
• Feedback from the visit to CGL – held on 23 June 2016.
• Quality Framework and Performance Measures for the Health Sector in Wirral.
• Suicide Rates.
• Future Arrangements and Work Programme for the Panel.

Resolved – That the report be noted.

The People Overview and Scrutiny Committee noted the report of the Chair that updated members on the current position regarding the Committee’s work programme as agreed for the 2016/17 municipal year.

The report informed on the process of developing and managing the scrutiny work programme for the municipal year. Members noted that the People Overview and Scrutiny Committee, in cooperation with the other two Overview and Scrutiny Committees, was responsible for proposing and delivering an annual work programme and that the work programme should align with the corporate priorities of the Council, in particular the delivery of the Wirral Plan pledges which fell within the remit of the Committee.

Members noted that the report provided an update regarding progress made since the last Committee meeting held on 8 September 2016 and that the current work programme was made up of a combination of scrutiny reviews, standing items and requested officer reports, providing the committee with an opportunity to plan and regularly review its work across the municipal year.

The Chair provided a verbal update on the approval of the Avoiding Admissions Scrutiny Review by Cabinet at its meeting on 3 October; and that the Community Pharmacies Scrutiny Review was to be considered by the People Overview and Scrutiny Committee at its next meeting; and the requirement for a Task and Finish Group to undertake a check on service user’s experiences of alternative provision following the decision to close Girtrell Court. 

Resolved – That

1)  the proposed People Overview & Scrutiny Committee work programme for 2016/17, be noted; and

2)  a Task & Finish group be established to undertake the forthcoming Re-provision of Respite Services Scrutiny Review – membership nominations to be provided to the Chair in due course.